A quarter of GP clinics in Hunter-New England and Central Coast have closed their books to patients and almost half are showing signs of financial trouble, a survey shows.
The district's Primary Health Network released the survey this week in a report on "general practice business viability".
Dr Milton Sales, who runs the Brunker Rd General Practice at Adamstown, said "there really aren't enough GPs in Newcastle".
"The issue of closed books will get worse as our ageing GPs retire," Dr Sales said.
He added that only 15 per cent of medical graduates were choosing to become GPs.
Dr Max Mollenkopf, who runs Whitebridge Medical Centre, said "general practice has been under attack for a number of years".
"A lot of patients struggle to afford care. As a profession, we feel deeply that we want everyone to have equitable access to care," Dr Mollenkopf said.
"The solution is a clear plan from the federal government for general practice funding that we can rely on, knowing it will be indexed and available."
The federal government's most recent increase of Medicare rebates was 4 per cent, but healthcare CPI for staff, rent and consumables rose by more than 6 per cent.
While clinics faced financial issues, Dr Sales said "the people who are most suffering are probably the one income, three kids family".
"They don't get benefits and have to choose which kid to take to the doctor."
The PHN report said solo GPs or small practices with two to five GPs were "less likely to be viable and sustainable".
"Larger practices with 16 or more GPs are significantly more viable than any other practice on average."
The survey, done from February to March, included 217 general practice businesses.
It found that 75 per cent of practices had "at least one GP with open books", while a quarter of practices had "closed books for all GPs".
Additionally, 49 per cent of general practice businesses were "displaying indicators of financial instability".
Despite the federal government boosting bulk-billing incentives, GP clinics say they are not enough.
Dr Sales said any extra revenue from the incentives would "disappear back to the state government".
As reported last month, the NSW government is hitting contracted doctors with payroll tax.
GP fees in Newcastle for a standard consultation will rise as high as $120 from this month, with most practices set to increase fees by $10 to $15 to cover the tax.
In the PHN survey, 46 per cent of general practices said rising rental costs were also affecting their "ability to cover costs".
"Our rent went up by $40,000 last year and $30,000 the year before because it's CPI linked. They were 6 and 5 per cent rises," Dr Sales said.
The clinic's rent rose to about $450,000.
"People sit in our waiting room and think this looks nice, but don't realise that every square metre is costing us a fortune, " said Dr Sales, half-joking.
The survey said 74 per cent of practices found attraction and retention of clinical staff a major barrier.
And a fifth of general practices reported a 20 per cent turnover of staff.
The report quoted one clinic as saying: "We need to book out every GP every day to break even".
